Complications and outcomes of operative treatment for acute perilunate injuries: a systematic review

Abstract

We systematically reviewed the incidence of complications and outcomes of different surgical methods for acute perilunate injury in the MEDLINE, Scopus, Embase and Cochrane Library databases. Forty-three articles with 880 patients were included. The most common complications were arthritis (30%), carpal instability (15%), avascular necrosis of the lunate (12%), complex regional pain syndrome (11%), and nonunion or avascular necrosis of the scaphoid (9%). In the meta-analysis, the mean scapholunate gap was 1.7 mm in the closed surgery group and 2.3 mm in the open surgery group, which was a statistically significant difference. The mean flexion–extension arc of the wrist and modified Mayo wrist score were better in the closed surgery group than in the open surgery group. However, these findings may relate to different cohorts in terms of injury severity. Therefore, the causal relationship between closed surgery and better outcomes may be uncertain as less severe subluxations are more likely to be treated closed.

Wrist & Hand

“…This systematic review from Suwon (South Korea) aimed to evaluate the complications and outcomes of operative surgical treatment for acute perilunate injuries. 4 The review included 43 articles with a total of 880 patients.…”

“…This systematic review from Suwon (South Korea) aimed to evaluate the complications and outcomes of operative surgical treatment for acute perilunate injuries. 4 The review included 43 articles with a total of 880 patients. The most common complications reported here were arthritis in 30%, carpal instability in 15%, avascular necrosis of the lunate in 12%, complex regional pain syndrome in 11%, and nonunion or avascular necrosis of the scaphoid in 9%.…”